As McConnell plan fails, will Democrats and Republicans work together to fix health care?

WASHINGTON — Senate Majority Leader Mitch McConnell once threatened that Republicans would have to work with Democrats if they couldn’t get their act together on a repeal and replace strategy for Obamacare.

It looks like that day might have come.

At a somber press conference in the Capitol on Tuesday, McConnell, R-Ky., announced that it appeared he could not get 50 Republicans to agree on an Obamacare replacement behind closed doors and conceded that the experience had been “very, very challenging.”

“We’ve demonstrated that Republicans by themselves are not prepared at this particular point to do a replacement,” he said, when asked if the GOP would now work with Democrats. “That doesn’t mean that the problems all go away.”

“There will be hearings about the crisis that we have,” he added.

McConnell also continued to insist that he would hold a vote to repeal Obamacare on a two-year delay to give Republicans and Democrats time to come up with a replacement. But at least four members of his caucus have nixed that idea, effectively making it impossible to pass such a measure.

“If they want to have a vote on that, fine,” said Sen. Amy Klobuchar, D-Minn. “But I think we all know where this is going to end up … Democrats and Republicans working on positive changes to the Affordable Care Act.”

Republican Sen. Lamar Alexander, chair of the Health, Education, Labor and Pensions Committee, announced late Tuesday that his committee would begin bipartisan hearings in the coming weeks on “how to stabilize the individual market.”

That move could signal the return to the “regular order” that Democrats — and some Republicans — have been calling for ever since McConnell decided to hammer out a bill reshaping the nation’s health care system entirely behind closed doors, skipping the regular committee process. The original group of senators working on the bill snubbed key GOP moderates such as Sens. Susan Collins, R-Maine, Shelley Moore Capito, R-W.V., and Lisa Murkowski, R-Alaska, which may have helped doom McConnell’s efforts.

“I think that opens up all kinds of opportunities on regular order,” Heidi Heitkamp, D-N.D., said of the failure of the GOP bill Tuesday. “And two of the people who do regular order the best are Lamar Alexander and [Sen.] Patty Murray [D-Wash.].” (Murray is the ranking member of Alexander’s committee.)

But it remains unclear if Republicans and Democrats can overcome their significant policy differences, as well a a simmering political animus, and fix the problems that both parties admit dog Obamacare’s individual marketplace — even in an open committee process.

Democratic Minority Leader Chuck Schumer, D-N.Y., mentioned several specific Democratic policy goals he’d like the committee to consider, such as bringing back billions of dollars in federal funding for reinsurance payments and making cost-sharing payments to insurance companies permanent. Currently, the Trump administration is in charge of making the cost-sharing payments to insurers, and it has repeatedly threatened to cut them off, which insurance executives argue destabilizes the markets.

Over the past six months, some top Republicans have seemed open to guaranteeing cost-sharing payments, acknowledging that insurance companies need that security to stabilize the markets. But that willingness was predicated on the assumption that the party would be able to repeal Obamacare. Now, cost-sharing payments will likely be portrayed on the right as a “bailout” for insurance companies, with no end in sight, making them politically risky to back.

Further complicating the Republican path forward is President Trump, who has repeatedly suggested that Republicans should “let Obamacare fail” and blame Democrats. The president would likely oppose any Republican attempts to work with Democrats to try to stabilize the markets.

“We’re not going to own it. I’m not going to own it,” Trump told reporters at the White House of the health care system Tuesday. “I can tell you the Republicans are not going to own it. We’ll let Obamacare fail, and then the Democrats are going to come to us.”

Asked whether he thought the acrimony was too strong in the Capitol for Democrats and Republicans to work together, Schumer told reporters, “Let’s find out.”